Public Sex Life H [v0.74 Public]
Special Instructions: Unzip and install apk. Grant storage permissions on first run! On first run you will get a prompt to copy the archive.rpa file to documents/Wills747/publicsexlife.h/game folder. Copy the rpa file to the directory indicated in game. (game will quit now) Restart the game. Advise keeping gl2 disabled unless you have a PowerVR gpu or experience video problems.
Public Sex Life H [v0.74 Public]
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Evidence-based guidelines for older adults communicate the benefits of a physically active lifestyle using frequency-, duration-, and intensity-based parameters. Similar to what is typically communicated to younger adults, public health physical activity guidelines promote at least 150 minutes/week of moderate-to-vigorous physical activity (MVPA) for older adults and include "brisk walking" as a primary example of an appropriate activity [3]. Variations on the message exist: the World Health Organization promotes at least 30 minutes of moderate intensity physical activity 5 days per week for older adults [4]. All older adults should avoid inactivity and some physical activity is considered better than none [5]; however, public health recommendations answer a pragmatic need to provide generalized guidance. Regardless of the message specifics, as framed, time- and intensity-based guidelines imply that this dose of physical activity should be taken over and above a baseline level which is yet to be quantified. This is problematic, since it is likely that this baseline level of non-exercise physical activity has been most susceptible to secular transitions in occupation in favour of desk jobs and reductions in physical demands of most other jobs, reliance on labour-saving devices to supplement or replace domestic tasks and other activities of daily living, dependence on motorized transportation, and an insidious and pervasive predilection for passive leisure time pursuits [6]. Since self-reported leisure time physical activity (specifically walking for exercise) increases in older adults with age [7], yet objectively monitored physical activity decreases [8], it is also likely that this baseline level of non-exercise physical activity is vulnerable to advancing age, disability, and chronic illness.
As noted above, there is no evidence to inform a moderate intensity cadence specific to older adults at this time. However, using the adult cadence of 100 steps/minute to denote the floor of absolutely-defined moderate intensity walking, and multiplying this by 30 minutes, produces an estimate of 3,000 steps. To be a true translation of public health guidelines these steps should be taken over and above activities of daily living, be of at least moderate intensity accumulated in minimally 10 minute bouts, and add up to at least 150 minutes spread out over the week [3,5,53]. Considering a background of daily activity of 5,000 steps/day [15,16], a computed translation of this recommendation produces an estimate of approximately 8,000 on days that include a target of achieving 30 minutes of MVPA, but approximately 7,100 steps/day if averaged over a week (i.e., 7 days at 5,000 plus 15,000 steps of at least moderate intensity). In reality, this background level of daily activity is likely to vary, and it is possible that steps/day values indicative of functional activities of daily living in some older adults (especially special populations living with disability or chronic illness) are much lower than 5,000 steps/day. Recognizing this potential, and as described above, the adult graduated step index has been extended to include 'basal activity' (
Tudor-Locke et al. [54] reported an age-specific analysis of BMI-criterion referenced and amalgamated data collected from around the world. For women aged 60-94 years of age the best cut point was 8,000 steps/day in terms of discriminating between BMI-defined normal weight and overweight/obesity. In men aged 51-88 years the value was 11,000 steps/day. The authors acknowledged that they had better confidence in the women's data since the men's value was based on a sparse sample size collected over a relatively wider age range. It is important to note that spring-levered pedometers are known to undercount steps related to obesity [65], so these BMI-referenced values can be questioned. However, even accelerometer-determined steps/day differ in a similar pattern across BMI-defined obesity categories [66]. Since pedometers are more likely to be used in clinical and public health applications, it remains important to present these pedometer-determined data as indicators of expected values in these free-living populations (that include obese individuals).
The correlation between age and preferred walking speed in a population study of older adults 60-86 years of age was -.34 (women) and -.41 (men) [74]. Those living with disability or chronic illness may walk at even slower speeds [75]. Overall, aging, disabled, and ill older adults may gradually lose their ability to walk at higher cadences and what remains is the "pottering" (i.e., random, unplanned movements) associated with activities of daily living that all ages appear to engage in to some extent [76]. Slow walking speed in older adults is strongly associated with increased risk of cardiovascular mortality [77]. Since public health guidelines for older adults continue to emphasize the importance of engagement in aerobic activities that are of at least moderate intensity, it follows that any step count translation also reflects this emphasis. Although pedometers have been widely criticized for not being sensitive to detecting slow walking, their ability to "censor" low force accelerations might actually be seen as a feature that permits a concerted focus on only those steps that are more likely to be beneficial to health [78].
Regardless, the interest in detecting even very low force accelerations is evident from research studies focused on physical activity behaviours of older adults [13,79] and especially of individuals living with disability and chronic illness [14] that have been adopting the StepWatch Activity Monitor (SAM, CYMA Corporation, Mountlake Terrace, WA). The SAM is an ankle worn-accelerometer that detects a "stride" or "gait cycle." To be interpreted relative to more traditional waist-mounted instruments (both accelerometers and pedometers), its output needs to be doubled and expressed as steps. However, this instrument is designed to be exceptionally sensitive to slow gaits [80] (and is also more likely to detect "fidgeting" activities [80]) and therefore its output would appear higher than that of more traditional pedometers [17]. For example, a sample of older adults (mean age 83 years) who wore the SAM for 6 consecutive days averaged approximately 10,000 steps/day [81], or 'active' if directly (and inappropriately) interpreted against the graduated step index based on pedometer output [15,16]. The SAM remains an important research tool, however, it is less practical for public health applications. No conversion factor exists at this time to assist in translation of SAM-detected steps to that of pedometers that have been more traditionally used in research and practice.
Another instrument, the ActiGraph accelerometer, is also known to be more sensitive to lower force accelerations ([82-84]) and its output from earlier models needed to be manipulated in order to interpret it against existing pedometer-based scales [15,16]. More recently, the manufacturers of this instrument have offered a 'low extension' option that can be selected, or deselected, depending on sensitivity requirements. Since pedometers are more likely to be adopted by a range of users including researchers, practitioners, and the general public, and since public health guidelines specifically emphasize MVPA (and not lighter intensity activities), the step-based translations presented in this article are intentionally more reflective of what would be expected from the use of good quality pedometers. Although the need to detect less forceful steps, especially in some clinical populations can be justified, it remains a concern that comparisons between datasets collected with different devices are hampered unless acceptable conversion factors to facilitate such interpretation can be determined.
Effective interventions include designing safer infrastructure and incorporating road safety features into land-use and transport planning, improving the safety features of vehicles; enhancing post-crash care for victims of road traffic crashes; setting and enforcing laws relating to key risks, and raising public awareness.
WHO also plays a key role in guiding global efforts by continuing to advocate for road safety at the highest political levels; compiling and disseminating good practices in prevention, data collection and trauma care; sharing information with the public on risks and how to reduce these risks; and drawing attention to the need for increased funding. To support these efforts WHO organizes and hosts, in collaboration with key partners including the Global Alliance of NGOs for Road Safety and YOURS: Youth for Road Safety, high profile advocacy events such as periodic UN global road safety weeks and the annual World Day of Remembrance for Road Traffic Victims. 041b061a72